Methods for detection of colorectal cancer

ABSTRACT

Particular genes are aberrantly and consistently expressed in both adenomas and carcinomas of the colon. Products of such genes provide stool and serum markers for colorectal neoplasia. One particular tumor marker, Renal Dipeptidase (RDP), is expressed at high levels in tumors and at greatly reduced levels in normal tissues. The elevated expression of RDP occurs early and remains elevated during the neoplastic process. RDP may therefore be especially useful as a diagnostic tool for the early detection of colorectal neoplasia, even of presymptomatic colorectal neoplasia.

BACKGROUND OF THE INVENTION

1. Technical Field of the Invention

The invention relates to the early detection of colorectal adenoma and carcinoma. In particular it relates to the detection of secreted or cell surface markers in easily collectible bodily samples.

2. Background of the Art

Colorectal cancer is the second leading cause of cancer death in the United States, with ˜130,000 patients diagnosed each year and ˜50,000 ultimately succumbing to the disease (1). Most colorectal cancers develop slowly, beginning as small benign colorectal adenomas which progress over several decades to larger and more dysplastic lesions which eventually become malignant. This gradual progression provides multiple opportunities for prevention and intervention. Indeed, benign adenomas can be detected and removed by simple colonoscopy and polypectomy, precluding the need for radical surgical and adjuvant treatments. It is therefore believed that early detection and removal of these benign neoplasms provides the best hope for minimizing morbidity and mortality from colorectal cancer. Various screening methods for detecting early colorectal tumors are available, such as fecal occult blood testing, sigmoidoscopy, and colonoscopy (reviewed in 2). However, none of these methods are optimal, and new approaches are needed.

BRIEF SUMMARY OF THE INVENTION

In a first embodiment a method is provided for detection of colorectal adenoma and carcinoma. An mRNA sample is isolated from feces of a subject. Renal dipeptidase mRNA in said mRNA sample is detected. The amount of renal dipeptidase mRNA in said mRNA sample is compared to amounts of renal dipeptidase mRNA in normal subjects. An elevated amount of renal dipeptidase mRNA in said mRNA sample is an indicator of colorectal adenoma or carcinoma in the subject.

According to another embodiment of the invention a method is provided for detection of colorectal adenoma or carcinoma. Epithelial cells are isolated from blood of a subject. An mRNA sample is isolated from the epithelial cells. Renal dipeptidase mRNA in said mRNA sample is detected. The amount of renal dipeptidase mRNA in said mRNA sample is compared to amounts of renal dipeptidase mRNA in normal subjects. An elevated amount of renal dipeptidase mRNA in said mRNA sample is an indicator of colorectal adenoma or carcinoma in the subject.

A third embodiment of the invention provides a method for detection of colorectal adenoma or carcinoma. Blood of a subject is contacted with a renal dipeptidase substrate. Activity of renal dipeptidase in said blood is determined by detection of increased reaction product or decreased renal dipeptidase substrate. The amount of activity of renal dipeptidase in blood of the subject is compared to that in normal subjects. An elevated amount of activity of renal dipeptidase in the blood of the subject is an indicator of colorectal adenoma or carcinoma in the subject.

According to another embodiment of the invention a method for detection of colorectal adenoma or carcinoma is provided. Feces of a subject is contacted with a renal dipeptidase substrate. Activity of renal dipeptidase in said feces is determined by detection of increased reaction product or decreased renal dipeptidase substrate.

The amount of activity of renal dipeptidase in feces of the subject is compared to that in normal subjects, wherein an elevated amount of activity of renal dipeptidase in the feces of the subject is an indicator of colorectal adenoma or carcinoma in the subject.

Another embodiment of the invention provides a method for detection of colorectal adenoma or carcinoma. An antibody is administered to a subject. The antibody specifically binds to renal dipeptidase and is labeled with a moiety which is detectable from outside of the subject. The moiety in the subject is detected from outside of the subject. An area of localization of the moiety within the subject but outside the proximal tubules of the kidney identifies colorectal adenoma or carcinoma.

Another method is also provided for detection of colorectal adenoma or carcinoma. An inhibitor of renal dipeptidase is administered to a subject. The inhibitor is labeled with a moiety which is detectable from outside of the subject. The moiety in the subject is detected from outside of the subject. An area of localization of the moiety within the subject but outside the proximal tubules of the kidney identifies colorectal adenoma or carcinoma.

According to yet another method for detection of colorectal adenoma or carcinoma, a substrate for renal dipeptidase is administered to a subject. The substrate is labeled with a detectable moiety. Feces are isolated from the subject. Renal dipeptidase reaction product or renal dipeptidase substrate with the detecable moiety is detected in the feces. An increased reaction product or decreased reaction substrate in the feces indicates colorectal adenoma or carcinoma in the subject.

Still another method for detection of colorectal adenoma or carcinoma is provided by the present invention. A substrate for renal dipeptidase is administered to a subject. The substrate is labeled with a detectable moiety. Blood from the subject is subsequently isolated. Renal dipeptidase reaction product or renal dipeptidase substrate with the detecable moiety is detected in the blood. An increased product or decreased substrate in the blood indicates colorectal adenoma or carcinoma in the subject.

Still another embodiment of the invention is a method for detection of colorectal adenoma or carcinoma. Renal dipeptidase in blood of a subject is detected and compared to the amount of renal dipeptidase in normal subjects. An elevated amount of renal dipeptidase in the blood of the subject is an indicator of colorectal adenoma or carcinoma in the subject.

Still another embodiment of the invention is a method for detection of colorectal adenoma or carcinoma. Renal dipeptidase in feces of a subject is detected and compared to the amount of renal dipeptidase in normal subjects. An elevated amount of renal dipeptidase in the feces of the subject is an indicator of colorectal adenoma or carcinoma in the subject.

Yet another embodiment of the invention is a method for detection of colorectal adenoma or carcinoma. An mRNA sample is isolated from feces of a subject. Macrophage inhibitory cytokine mRNA is detected in the mRNA sample. The amount of macrophage inhibitory cytokine mRNA in said mRNA sample is compared to amounts of macrophage inhibitory cytokine mRNA in normal subjects. An elevated amount of macrophage inhibitory cytokine mRNA in said mRNA sample is an indicator of colorectal adenoma or carcinoma in the subject.

Another embodiment of the invention is a method for detection of colorectal adenoma or carcinoma. Epithelial cells are isolated from blood of a subject. An mRNA sample is isolated from the epithelial cells. Macrophage inhibitory cytokine mRNA is detected in said mRNA sample. The amount of macrophage inhibitory cytokine mRNA in said mRNA sample is compared to amounts of macrophage inhibitory cytokine mRNA in normal subjects. An elevated amount of macrophage inhibitory cytokine mRNA in said mRNA sample is an indicator of colorectal adenoma or carcinoma in the subject.

Still another embodiment of the invention is a method for detection of colorectal adenoma or carcinoma. Macrophage inhibitory cytokine in blood of a subject is detected and compared to the amount of macrophage inhibitory cytokine in normal subjects. An elevated amount of macrophage inhibitory cytokine in the blood of the subject is an indicator of colorectal adenoma or carcinoma in the subject.

Still another embodiment of the invention is a method for detection of colorectal adenoma or carcinoma. Macrophage inhibitory cytokine in feces of a subject is detected and compared to the amount of macrophage inhibitory cytokine in normal subjects. An elevated amount of macrophage inhibitory cytokine in the feces of the subject is an indicator of colorectal adenoma or carcinoma in the subject.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1.A, Distribution of the fold changes of differentially expressed transcript tags. Transcripts in which the significance criterion was met (p<0.05, a total of 957 tags) in the comparisons between normal and adenoma or normal and cancer are plotted in the figure. The ratios of adenoma to normal and cancer to normal were plotted on a log scale. The shaded box in (FIG. 1.A) and enlarged in (FIG. 1.B) encloses the transcript tags detailed in Table 3. The two unlabeled dots correspond to tags whose differential expression could not be confirmed by quantitative PCR suggesting that the tags were derived from different transcripts than the ones indicated in Table 3.

FIG. 2. Quantitative PCR analysis of genes elevated in both adenomas and cancers. Quantitation of expression of genes in tumors and matched normal tissues from five patients (Pt) are shown as fold elevation over that in matched normal colonic mucosa. Each bar represents the average of three independent measurements. TGFBI, LYS, RDP, MIC-1, REGA, and DEHL are as described in Table 3.

FIG. 3. Quantitative PCR analysis of genes decreased in both adenomas and cancers. Quantitation of expression of genes in tumors and matched normal tissue from five patients (Pt) are shown as a fraction of matched normal. Each bar represents the average of three independent measurements. CA2 and DRA are described in Table 4. Dual Specificity Phosphatase (DUSP1), and Acid Sphingomylenase-like phosphodiesterase (ASML3a) represented transcripts that were repressed but did not meet the stringent criteria required for inclusion in Table 4. SAGE data indicated that DUSP1 was 5- and 76-fold repressed in adenomas and cancers, respectively. ASML3a was 15-fold repressed in both adenoma and cancer.

FIG. 4. Quantitative PCR analysis of mRNA from purified epithelial cells of genes elevated in both adenomas and cancers. Quantitation of expression of genes in the purified normal (N) or cancer (Ca) epithelial cells taken from two patients are shown as fold elevation over matched normal. Genes examined were the same as in FIG. 2.

FIG. 5A-FIG. 5E. In-situ hybridization analyses of elevated genes. Genes examined were REGA (FIG. 5A), TGFBI (FIG. 5B), LYS (FIG. 5C), RDP (FIG. 5D), and MIC-1 (FIG. 5E). Positive cells appear red, arrows point to clusters of malignant epithelial cells, and arrow heads point to macrophages.

FIG. 6. Inhibitors of renal dipeptidase demonstrate inhibition constants ranging from 0.6 nM to 19.5 nM.

FIG. 7. A comparison of the inhibitors shown in FIG. 6. compares the inhibition rate as a function of concentration of inhibitor.

FIG. 8. Substrates of renal dipeptidase are shown.

FIG. 9 shows the difference in activity of renal dipeptidase found in adenomas, cancer, and metastases compared to normal colonic tissue.

DETAILED DESCRIPTION OF THE INVENTION

It is a finding of the present invention that particular genes are aberrantly and consistently expressed in both adenomas and carcinomas of the colon. Products of such genes provide cellular and serum markers for colorectal neoplasia. The ideal tumor marker would be expected to have several characteristics. First, it should be expressed at high levels in tumors and at greatly reduced levels in normal tissues. Second the elevated expression should occur early and remain elevated during the neoplastic process. Third, such a marker should be elevated in the majority of clinical samples. Fourth, the marker should be cell surface or secreted to facilitate its detection. We have identified several genes that appear to meet all of these criteria and may therefore be especially useful as diagnostic tools for the early detection of colorectal neoplasia, even of presymptomatic colorectal neoplasia. Any of the markers identified in Tables 3 and 5 can be used, particularly Renal Dipeptidase and Macrophage Inhibitory Cytokine.

Serum markers can be found and detected in whole blood, serum, plasma, or fractions thereof. These are collectively referred to as “blood” herein. Markers can also be found in stool. Samples for testing can be feces or processed or fractionated feces. All such samples are referred to herein as “feces.”

Inhibitors of markers which are enzymes, such as Renal Dipeptidase, can be used as affinity reagents for labeling the marker. Preferably the inhibitors are those which bind irreversibly. Alternatively they are ones which bind and release, but release at a slow rate. Inhibitors with suitably slow release rates are those which have a binding half-life of greater than 30 minutes, or 1, 2, 3, 5, 8, or 10 hours. Many inhibitors of Renal Dipeptidase are known, including the commercially available Cilastatin, and phosphinic acid inhibitors. See Parsons et al., “A new class of potent, slowly reversibly dehydropeptidase inhibitors,” Biochemistry International, vol. 23, pp. 1107-1115, 1991. Inhibitors which covalently bind to and/or modify Renal Dipeptidase are also known and can be used. See Wu and Mobashery, “Targeting renal dipeptidase (dehydropeptidase I) for inactivation by mechanism-based inactivators,” J. Med. Chem., vol. 34, pp. 1914-1916, 1991. Some inhibitors mimic transition states between substrates and product. Some useful inhibitors are shown in FIG. 6. These include inhibitors having halogen substitutions. Such inhibitors can be readily made using radioactive halogens for ready labeling of renal dipeptidase and easy detection. Similar inhibitors of other enzymes are also known in the art and can be used. Inhibitors can be labeled using any detectable moiety known in the art, including but not limited to fluors and radioactive atoms.

RNA for any of the markers can be detected using any of the known techniques in the art. Preferably an amplification step will be used, because the amount of RNA for the marker is expected to be very small from the sources contemplated. Suitable techniques include RT-PCR, hybridization of copy mRNA (cRNA) to an array of nucleic acid probes, and Northern blotting.

Protein forms of the markers can be detected using any techniques known in the art. These include activity assays, immunological assays, binding to specific ligands, etc. Particularly suitable assays for Renal Dipeptidase include using L-L amino acid dipeptide substrates and L-D amino acid dipeptide substrates. Substrates which can be used for assaying renal dipeptidase are shown in FIG. 8, and include the generic structures for dipeptides and dehydrodipeptides. ε (DNP)-L-Lysine-D-Amp can also be used as a substrate, yielding a colored product. Substrates for other enzymes can be used similarly to assess the presence of the tumor marker enzyme in the body or in a body sample. Such substrates can be labeled with detectable moieties, including but not limited to fluors and radioactive atoms. One particularly useful labeling scheme employs a substrate which is labeled with two moieties on opposite sides of the substrate cleavage site. One of the moieties is fluorescent and one of the moieties is a quencher. When the two moieties are close, as in an intact substrate, the fluorescence of the fluorescent moiety is quenched. Upon cleavage the quenching is released and an increase in fluorescence is observed.

As mentioned above, inhibitors can also be labeled and used for detecting suitable markers. In addition, antibodies can be used to label protein forms of the markers. The antibodies can be labeled as is known in the art. Suitable radioactive atoms for use in labeling inhibitors, substrates, and antibodies include In-111, I-123, Tc-99m, Re-186, Re-188, Ga-67, Ga-68, Tl-201, Fe-52, Pb-203, Co-58, Cu-64, I-124, I-125, I-131, At-210, Br-76, Br-77, and F-18 and others known in the art for such purposes. Contrast enhancement agents can also be attached to the substrates, inhibitors, or antibodies. Such agents include gadolinium. Moreover, imaging techniques can be used to detect such labels within the body. An example of an imaging technique which can be used is spiral computer tomography. For this technique, the detecting agent, such as inhibitor or antibody can be linked to a contrast enhancing agent. Other detection means that can be used include gamma cameras, magnetic resonance imaging, planar scintigraphic imaging, SPECT imaging, PET imaging, and ultrasound imaging. Thus markers can be detected both in situ in the body or in vitro in an isolated body sample.

Epithelial cells can be isolated from blood or other tissue samples to enrich for the markers or their mRNAs. Epithelial cells can be isolated, inter alia, by immunoaffinity techniques. Such a technique is described in more detail below.

Substrates of enzymic markers can be administered to subjects and the reaction products measured in body samples. Inhibitors can be administered to subjects and the subject can be imaged to detect the inhibitor bound to the marker. Such markers are preferably those which are not secreted proteins, but rather are those which are anchored to a tumor. Typical modes of administration of such agents can be any which is suitable, including but not limited to per os, intravenous, intramuscular, intraarterial, subdermal, transdermal, and rectal.

A high background of certain markers may obscure detection of increased expression. In such a situation, one can use tumor-specific glycoforms as a means of distinguishing between the background marker and the marker that is due to the tumor. Tumor-specific glycoforms of Renal Dipeptidase and MIC-1 bind to LPHA, an L lectin from Phaseolus vulgaris hemagglutinin, and thus can be distinguished on that basis. Other lectins such as with similar specificity for tumor-specific glycoforms, such as Sambucus Nigra Lectin isolated from Sambucus nigra (elderberry) bark can be used as well.

Normal subjects are used as a comparison to the test subjects to determine whether the amounts of markers observed in the feces or blood are elevated. Preferably the normal subjects have been confirmed as tumor-free by colonoscopy. More preferably several samples are pooled or their individual values are averaged to arrive at a normal value.

Some of the most highly overexpressed genes found in colorectal adenomas and colorectal cancers are discussed below. Regenerating Islet Derived Pancreatic Stone Protein, encoded by the REGA gene, is a secreted polypeptide first found in pancreatic precipitates and stones from patients suffering from chronic pancreatitis (7). The cDNA encoding this protein was isolated from a random screen of genes highly expressed in a regenerating-islet derived cDNA library (8) and subsequently shown to be elevated in colorectal cancers (9). More recently, REGA was isolated in a hybridization-based screen for genes elevated in colorectal cancers and shown to be elevated in many colorectal adenocarcinomas (10). Consistent with these published observations, we observed a strong elevation in expression of REGA in unpurified tumors, and a similar elevation in one purified tumor. In situ hybridization experiments demonstrated REGA to be strongly expressed in the epithelial cells of the tumors, with no expression evident in the stroma (FIG. 5A).

TGFB-induced gene (TGFBI) encodes a small polypeptide of unknown function initially isolated through a differential display screen for genes induced in response to treatment with TGF β (11). The protein is expressed in the keratinocytes of the cornea (12) and, interestingly, germline mutations of this gene cause familial corneal dystrophies (13). TGFBI was previously shown to be among the most significantly elevated genes in colorectal cancers (4), and our new data show that it is expressed at high levels in adenomas as well. Quantitative PCR results demonstrated strong elevation both in unpurified tumors and purified tumor epithelial cells. Accordingly, in situ hybridization experiments revealed TGFBI to be expressed in many cell types, in both the stromal and epithelial compartments (FIG. 5B).

Lysozyme (LYS, 1,4-β-N-acetylmuramidase, EC 3.2.1.17) is an enzyme with bacteriolytic activity (14) capable of cleaving β-1,4 glycosidic bonds found in the cell walls of gram-positive bacteria. The enzyme is expressed in the secretory granules of monocytes, macrophages and leukocytes, as well as in the Paneth cells of the gastrointestinal tract. Fecal lysozyme levels are dramatically elevated in patients with inflammatory bowel disease (15, 16), and serum lysozyme activity is significantly elevated in patients with sarcoidosis (17), both of which are diseases characterized by aberrant chronic inflammation. Furthermore, lysozyme immunoreactivity has been observed in the epithelial cells of both adenomas and carcinomas of the large intestine (18). In our study, the degree of elevation of expression of LYS varied from 4-fold to 55-fold in the unpurified samples. In contrast, the degree of elevation of expression of LYS observed in purified epithelial cells was only 2-5 fold. This suggested that a substantial portion of the expression for this gene in the tumors could have been derived from non-epithelial cells. Consistent with this hypothesis, in situ hybridization experiments revealed that the majority of LYS mRNA was present in a stromal component that appeared to be macrophages (FIG. 5C). The expression of LYS in the macrophage compartment of colorectal tumors was also supported by its high representation in a SAGE library constructed from hematopoietic cells (CD45+, CD64+, CD14+) purified from colorectal tumors (602 LYS tags/56,643 total tags) (6).

One interesting gene identified in the current study is renal dipeptidase (RDP). RDP is a GPI-anchored enzyme whose major site of expression is the epithelial cells of the proximal tubules of the kidney (reviewed in (19)). The enzyme has been extensively analyzed with respect to its catalytic mechanism and inhibition kinetics by a variety of synthetic inhibitors. RDP is unique among the dipeptidases in that it can cleave amide bonds in which the C-terminal partner is a D amino acid, providing excellent opportunity for the development of specific probes for its detection in vivo. Quantitative PCR revealed RDP to be markedly elevated in both unpurified and purified tumor epithelial cells, and in situ hybridization experiments showed that RDP was exclusively localized to epithelial cells of colorectal tumors (FIG. 5D).

Macrophage Inhibitory Cytokine (MIC-1) is a small polypeptide of 16 kDa first isolated from a differential screen for genes that were induced upon macrophage activation (20). Concurrently, it was identified in the IMAGE database by a search for molecules homologous to the Bone Morphogenic Protein/TGF β family of growth and differentiation factors (21). In addition to being highly expressed in activated macrophages, MIC-1 has been noted to be highly expressed in placenta and the epithelial cells of normal prostate. In the current study, we found MIC-1 expression to be elevated between 7 and 133 fold in the unpurified tumors. As observed for LYS, the purified tumor cells demonstrated significant but less elevation of expression of MIC-1 (5 to 7-fold) indirectly implicating stromal expression to be partly responsible for the dramatic elevation seen in some tumors. Consistent with this hypothesis, in situ hybridization experiments revealed expression in both the epithelium of the tumor, and in a cell type resembling infiltrating macrophages (FIG. 5E).

EXAMPLES Example 1 SAGE

In an effort to identify potential molecular markers of early colorectal tumors, we have here analyzed gene expression in benign and malignant colorectal tumors in an unbiased and comprehensive fashion. We used SAGE to analyze global gene expression in normal, benign and malignant colorectal tissue. SAGE is a gene expression profiling method that associates individual mRNA transcripts with 15-base tags derived from specific positions near their 3′ termini (3). The abundance of each tag provides a quantitative measure of the transcript level present within the mRNA population studied. SAGE is not dependent on pre-existing databases of expressed genes, and therefore provides an unbiased view of gene expression profiles. For the current study, SAGE libraries derived from two samples of normal colonic epithelium, two colorectal adenomas, and two colorectal cancers were analyzed. These libraries contained a combined total of 290,394 transcript tags representing 21,343 different transcripts (Table 1).

TABLES 1 Summary of SAGE data Total number Number of of tags different transcripts SAGE Library observed observed* Normal Colorectal Epithelium NC-1  49,610 9,359 NC-2  48,479 9,610 Adenomas Ad-A  52,573 11,167 Ad-B  42,661 9,483 Cancers Tu-98  41,371 9,780 Tu-102  55,700 11,039 Total 290,394 21,343 *To minimize the effect of potential sequencing errors, only tags observed more than once in a given SAGE library were counted to give a conservative estimate of the minimum number of different transcripts analyzed.

Two comparisons were performed, one between the adenoma and normal samples, and one between the cancer and normal samples. These comparisons revealed 957 transcript tags that were differentially expressed more than 2-fold between normal and tumor tissue (Table 2). A comparison of the fold change in adenomas versus cancers revealed that many transcripts were similarly elevated or repressed in both adenomas and cancers although the magnitude often varied (FIG. 1A). Indeed the majority (79%) of comparisons were in quadrants of the plot indicative of concordant elevation.

TABLE 2 Differentially expressed transcripts in benign and malignant tumor colorectal tissue Elevated in both Repressed in Total transcripts Fold change in Elevated in Elevated in adenomas and Repressed in Repressed in both adenomas differentially expression adenomas^(a) cancers^(a) cancer^(a) adenomas^(b) cancers^(b) and cancers^(b) expressed 2 346 170 50 313 380 192 957 4 263 119 23 225 270 117 735 10 160 79 10 134 157 58 462 20 49 40 9 72 52 23 181 ^(a)Elevated transcripts showed a significantly different (P < 0.05) tag count between normal and tumor tissue, were expressed in both tumor tissues analyzed, and had an expression level that was higher in the tumors than in the normals by the fold indicated in column one. For the purposes of calculation, 0.5 was substituted for the denominator when no tags were detected in the normal samples. ^(b)Repressed transcripts showed a significantly different (P < 0.05) tag count between normal and tumor tissue, were expressed in both normal tissues analyzed and had an expression level that was lower in the tumors than in the normals by the fold indicated in column one.

From both practical and biological perspectives, those changes showing the greatest magnitude were deemed the most interesting. In this regard, 49 tags were identified to be elevated by ≧20-fold in the adenomas and 40 were elevated by ≧20-fold in the cancers (Table 2). Conversely, there were 72 transcripts that were decreased by ≧20-fold in adenomas and 52 decreased by ≧20-fold in the cancers (Table 2).

There were nine transcripts that were elevated by ≧20-fold in both adenomas and cancers (FIG. 1B and Table 3) and 23 that were repressed by ≧20-fold (Table 4). Other elevated and repressed transcripts are shown in Table 5. Tags for the transcripts shown in Table 5 are listed as SEQ ID NO: 33-334. We were especially interested in genes whose products were predicted to be secreted or displayed on the cell surface, as these would be particularly suitable for the development of serologic or imaging tests for presymptomatic neoplasia, respectively. We were able to identify six such genes (TGFBI, LYS, RDP, MIC-1, REGA and DEHL) from among those whose transcript tags were elevated in both adenoma and carcinoma SAGE libraries.

TABLE 3 Transcripts most elevated in adenomas and cancers^(a) Normal Adenomas Cancers Tag Sequence NC-1 NC-2 AD-A1 AD-B2 Tu-98 Tu-102 Transcript name ATGTAAAAAA 0 0 26 32 2 12 Lysozyme (LYS) TAATTTTTGC 0 1 99 12 20 37 Differentially Expressed in Hematopoietic Lineages (DEHL) GTGTGTTTGT 0 0 17 29 17 15 Transforming Growth Factor, Beta-Induced (TGFBI) GTGCTCATTC 0 0 13 7 2 10 Macrophage Inhibitory Cytokine, 1 (MIC-1) TTCCAGCTGC 0 0 7 6 2 9 Adaptor-related Protein Complex 2, alpha 2 subunit^(b) ACCATTGGAT 0 0 3 10 3 9 Interferon Induced Transmembrane Protein 1 (9-27)^(b) TTTCCACTAA 0 0 8 4 4 6 Regenerating Islet-Derived 1 alpha (REGA) CAAGGACCAG 0 0 5 6 10 12 Renal Dipeptidase (RDP) AGGACCATCG 0 0 8 2 1 18 Defensin, Alpha 5, Paneth cell-specific^(c) ^(a)These tags (SEQ ID NOS: 1-9) displayed at least twenty fold elevation in both neoplastic states. The numbers given are the raw tag counts for each tag observed in each library. Transcript name provides a description of matching UniGene cluster (Build Mar. 13, 2001). Rows shown in bold are genes confirmed by quantitative PCR to be differentially expressed. ^(b)Differential expression could not be confirmed by quantitative PCR suggesting that the tag was derived from a different transcript than the one indicated. ^(c)Not tested.

TABLE 4 Transcripts most repressed in adenomas and cancers^(a) Normal Adenoma Cancer Tag Sequence NC-1 NC2 AD-A1 AD-B Tu-981 Tu-102 UNI ID Transcript name GTCATCACCA 35 22 0 0 0 0 32966 Guanylate Cyclase Activator 2B CCTTCAAATC 29 17 0 0 1 0 23118 Carbonic Anhydrase I TCTGAATTAT 24 16 0 0 1 0 50964 Carcinoembryonic Antigen-Related Cell Adhesion Molecule 1 TTATGGTGTG 11 17 0 0 0 0 271499 ESTs CTGGCAAAGG 14 22 1 0 0 0 72789 hypothetical protein FLJ20217 AGGTGACTGG 10 14 0 0 0 0 No Match CTTATGGTCC 36 11 0 1 1 0 179608 Retinol Dehydrogenase Homolog ATGATGGCAC 12 32 1 0 1 0 84072 Transmembrane 4 Superfamily Member 3 GTCCGAGTGC 17 3 0 0 0 0 3337 Transmembrane 4 Superfamily Member 1 ATTTCAAGAT 35 21 0 2 1 0 155097 Carbonic Anhydrase II (CA2) CAAGAGTTTC 14 2 0 0 0 0 183617 ESTs GCCATCCTCC 9 13 0 1 0 0 No Match ACCCAACTGC 12 3 0 0 0 0 232604 Homo sapiens cDNA: FLJ22675 fis, clone HSI10553 GCCCACGTCA 7 8 0 0 0 0 No Match TTTGGTTTCA 2 13 0 0 0 0 No Match CTCAGAACTT 18 3 1 0 0 0 194710 N-acetylglucosaminyl transferase 3, mucin type CCAACACCAG 9 19 1 0 0 1 181165 Eukaryotic Translation Elongation Factor 1 Alpha 1 GCCACATACT 3 9 0 0 0 0 4984 KIAA0828 protein GTATTGGGGC 5 7 0 0 0 0 No Match CCGGCTTGAG 7 4 0 0 0 0 2722 Inositol 1,4,5-trisphosphate 3-Kinase A GATATGTAAA 1 10 0 0 0 0 227059 Chloride Channel, Calcium Activated, Family Member 4 CATAGGTTTA 66 39 4 1 5 0 1650 Solute Carrier Family 26, member 3 (DRA) GTCCTGAACA 7 3 0 0 0 0 78546 ATPase, Ca++ Transporting, Plasma Membrane 1 ^(a)These tags (SEQ ID NOS: 10-32) displayed at least twenty fold decrease in both neoplastic states. The numbers given are the raw tag counts for each tag observed in each library. Transcript name provides a description of matching UniGene cluster (Build Mar. 13, 2001). Rows shown in bold are genes that were tested and confirmed by quantitative PCR to be differentially expressed.

SAGE. For the initial SAGE³ of benign tumors, fresh adenomas were obtained from surgical specimens derived from FAP patients. Adenomas from FAP patients were employed because of the ready availability of small lesions and the certainty of inactivation of the APC pathway which initiates the formation of the majority of sporadic tumors. After histopathological verification of the neoplastic nature of the lesion (>70% neoplastic cells), total RNA was isolated by solubilizing the tissue in RNAgents Lysis Buffer (Promega, Madison, Wis.) followed by ultracentrifugation over a cesium chloride gradient. mRNA selection was performed from the purified total RNA using oligo(dT) cellulose (Life Technologies, Gaithersburg, Md.). Two adenoma SAGE libraries were prepared as described (3, 4) and sequenced to a total depth of over 90,000 transcript tags. For SAGE of normal and malignant tissues, four previously described normal (NC-1 and NC-2) and primary cancer (Tu-98 and Tu-102) SAGE libraries were employed (4). In collaboration with the Cancer Genome Anatomy Project (CGAP) (5), the analyses of these libraries was extended from a total of 123,046 transcripts in the previously published work to 195,160 transcripts in the current work. Tags were extracted from the raw sequence data and, after excluding repeated ditags, linker sequences, and tags from the polyrnorphic Major Histocompatibility loci, the resulting tag libraries were compared and statistical analysis performed using SAGE software, version 4.0. Data from the libraries are publicly available at the Uniform Resource Locator (URL) address for the http file type found on the www host server that has a domain name of ncbi.nlm.nih.gov, and a path to the directory SAGE, and detailed SAGE protocols are available at the Uniform Resource Locator (URL) address for the http file type found on the www host server that has a domain name of sagenet.org, and file name of sage_protocol.htn.

Example 2 RT-PCR

To verify the increased expression of these six genes, we used quantitative RT-PCR techniques to analyze the expression in seven colorectal neoplasms (three sporadic adenomas and four sporadic cancers) and matched normal colonic mucosa. For these assays, specific primers were developed that resulted in amplification from cDNA but not genomic DNA. Controls were provided by similar quantitative PCR assays of a gene whose expression was found to be very similar in the SAGE libraries of normal and neoplastic colon (β-amyloid precursor protein). The quantitative PCR experiments verified that five of the six selected genes (TGFBI, LYS, RDP, MIC-1, REGA) were expressed at significantly higher levels in every neoplastic sample analyzed compared to patient-matched normal mucosa (FIG. 2). Several tumors exhibited ≧20-fold higher levels of the studied transcripts compared to their patient-matched normal colonic mucosa, as predicted by SAGE. Another control was provided by the quantitative PCR analysis of four genes whose expression was observed to be reduced in the SAGE libraries prepared from adenomas and cancers compared to those from normal colonic mucosa. As shown in FIG. 3, the quantitative PCR confirmed the lower levels of expression of each of these genes, emphasizing that the dramatic elevations in expression observed in FIG. 2 represented gene-specific phenomena. Quantitative PCR. Tumors were collected, snap frozen, and stored at −80° C. They were verified to be predominantly composed of neoplastic cells by histopathological analysis, mRNA was isolated from tumors and patient-matched normal colonic mucosa using QuickPrep reagents (Amersham Pharmacia Biotech UK, Buckinghamshire, England), and single-stranded cDNA was synthesized using Superscript II (Life Technologies, Gaithersburg, Md.). Quantitative PCR was performed using an iCycler (Bio-Rad, Hercules, Calif.), and threshold cycle numbers determined using iCycler software, version 2.1. Reactions were performed in triplicate and threshold cycle numbers averaged. All genes examined were normalized to a control gene (β-amyloid precursor protein, shown by SAGE to be expressed at equivalent levels in all colorectal samples), and fold induction calculated according to the formula 2^((Rt-Et))/2^((Rn-En)) where Rt is the threshold cycle number for the Reference gene observed in the tumor, Et is the threshold cycle number for the Experimental gene observed in the tumor, Rn is the threshold cycle number for the Reference gene observed in the normal, and En is the threshold cycle number for the Experimental gene observed in the normal. The primers used for quantitative PCR were obtained from GeneLink (Hawthorne, N.Y.), and their sequences are available upon request.

Example 3 Expression in Isolated Epithelial Cells

The quantitative PCR data obtained from mRNA isolated from whole tumors provided independent evidence that SAGE provided an accurate indication of gene expression changes in colorectal neoplasia. However, neither analysis identified the cell types responsible for the increased expression. Non-neoplastic stromal cells within tumors may be considerably different than those in normal colonic mucosa (6), and the epithelial derivation of gene expression differences cannot reliably be concluded without direct supporting evidence. We therefore sought to determine if the epithelial cells of cancers express elevated levels of the six genes depicted in FIG. 2. First, we affinity-purified cancerous and patient-matched normal epithelial cells from fresh surgical specimens using immunomagnetic beads directed to the pan epithelial marker Ber-EP4, prepared cDNA and performed quantitative PCR analysis to determine the expression levels of the elevated genes as above. Elevated expression was observed in the purified tumor epithelial cells for each of the six genes examined (FIG. 4), demonstrating that at least some of the increased expression was derived from epithelial cells. However, relative expression of LYS was not as prominent or reproducible in the purified epithelial cells as in the mRNA from the unfractionated tumors, suggesting that other cell types might have contributed transcripts from this gene.

Epithelial cell immunoaffinity purification. Tumor epithelial cells were purified using a modification of the procedure previously developed for the isolation of tumor endothelial cells (6). In brief, fresh surgical specimens of tumor and matched normal tissue were obtained and digested with collagenase and the resulting material filtered through a nylon mesh to obtain single cell suspensions. The cells were then bound to a mixture of anti-CD14 and anti-CD45 immunomagnetic beads (Dynal, Oslo, Norway) to deplete the population of hematopoetic cells (negative selection). The remaining cell suspension was then incubated with anti-Ber-EP4 immunomagnetic beads to isolate epithelial cells (positive selection). Purified cells were lysed directly on the beads and mRNA purified using QuickPrep reagents (Amersham Pharmacia Biotech UK, Buckinghamshire, England).

Example 4 In situ Hybridization in Multiple Tumors

We performed in situ hybridization to RNA in frozen sections of tumors for five of the genes showing the most consistent elevation. DEHL was found to be elevated in only five of the nine tumors examined and was not investigated further. To increase the sensitivity of detection, we generated several RNA probes for each tested gene using in vitro transcription techniques. The results obtained are discussed below in conjunction with brief overviews of each of the five genes of interest.

In situ Hybridization. Non-radioactive in situ hybridization was performed as described (6). For each gene analyzed, a cocktail of anti-sense probes made through in vitro transcription were employed to increase sensitivity. The primers used to generate templates for the synthesis of the in situ riboprobes were obtained from GeneLink (Hawthorne, N.Y.), and their sequences are available upon request.

The results summarized above show that although a large number of tags are observed in the colorectal tissues analyzed, only a small fraction (957/21,343, <5%) were expressed differentially in benign or malignant neoplastic tissues. A similarly small fraction of genes (66/4000, 1.7%) were found to be aberrantly expressed in colorectal neoplasms using oligonucleotide arrays (22). Analysis of these differentially expressed genes not only has the potential to provide insights into the biology of human neoplasia but also may have clinically useful applications. One of the most exciting potential applications concerns the identification of genes whose products provide cellular and serum markers for colorectal neoplasia. In the current study, we identified several genes that appeared to meet all of these criteria and may therefore be especially useful as diagnostic tools for the early detection of presymptomatic colorectal neoplasia. Indeed, the product of one of these genes (MIC-1), has recently been found to be elevated in the serum of patients with colorectal and other cancers, providing further validation of this approach (24).

While the invention has been described with respect to specific examples including presently preferred modes of carrying out the invention, those skilled in the art will appreciate that there are numerous variations and permutations of the above described systems and techniques that fall within the spirit and scope of the invention as set forth in the appended claims.

TABLE 5 Tag_Sequence NC1 NC2 AD1 AD2 CA1 CA2 UNI ID Description AAAAGAAACT 1 3 33 52 7 16 172182 poly(A)-binding protein, cytoplasmic 1 AACGAGGAAT 8 0 24 26 17 23 AAGAAGATAG 6 6 28 25 21 34 184776 ribosomal protein L23a AATAGGTCCA 12 9 32 36 22 22 113029 ribosomal protein S25 ACAACTCAAT 1 1 7 7 8 6 244125 EST ACAACTCAAT 1 1 7 7 8 6 75922 brain protein 13 ACATCATCGA 10 18 50 66 34 46 182979 ribosomal protein L12 ACCATTGGAT 0 0 3 10 3 9 146360 interferon induced transmembrane protein 1 (9-27) ACCTGTATCC 5 3 20 6 26 35 182241 interferon induced transmembrane protein 3 (1-80) ACTCCAAAAA 9 12 21 65 21 37 133230 ribosomal protein S15 AGCACCTCCA 37 37 108 81 57 108 75309 eukaryotic translation elongation factor 2 AGGACCATCG 0 0 8 2 1 18 AGGGCTTCCA 26 41 74 108 50 85 29797 ribosomal protein L10 ATGGCTGGTA 18 46 79 75 81 136 182426 ribosomal protein S2 ATGTAAAAAA 0 0 26 32 2 12 178112 DNA segment, single copy probe LNS-CAI/LNS-CAII (deleted in polyposis ATGTAAAAAA 0 0 26 32 2 12 234734 lysozyme (renal amyloidosis) ATGTAAAAAA 0 0 26 32 2 12 83715 Sjogren syndrome antigen B (autoantigen La) ATTCTCCAGT 8 20 20 48 43 28 234518 ribosomal protein L23 CAAGGACCAG 0 0 5 6 10 12 109 dipeptidase 1 (renal) CAATAAATGT 8 6 40 76 33 67 179779 ribosomal protein L37 CAGCTCACTG 4 17 9 35 21 24 158675 ribosomal protein L14 CATTTGTAAT 48 27 102 57 36 125 CCTAGCTGGA 16 27 58 45 48 66 182937 peptidylprolyl isomerase A (cyclophilin A) CCTTCGAGAT 6 12 13 29 7 41 76194 ribosomal protein S5 CTCCTCACCT 7 13 38 36 24 75 242908 lecithin-cholesterol acyltransferase CTGACTTGTG 0 0 1 20 9 2 77961 major histocompatibility complex, class I, B CTGGGTTAAT 14 24 84 83 42 112 126701 ribosomal protein S19 CTGTTGATTG 13 3 60 38 32 27 249495 heterogeneous nuclear ribonucleoprotein A1 CTGTTGGTGA 9 19 37 59 31 61 3463 ribosomal protein S23 GAAAAATGGT 7 12 49 47 25 27 181357 laminin receptor 1 (67 kD, ribosomal protein SA) GAGTCAGGAG 2 0 8 6 9 7 181271 CGI-120 protein GCATAATAGG 11 16 22 54 50 21 184108 ribosomal protein L21 (gene or pseudogene) GCATTTAAAT 1 2 10 18 12 7 261802 eukaryotic translation elongation factor 1 beta 1 GCATTTAAAT 1 2 10 18 12 7 275959 eukaryotic translation elongation factor 1 beta 2 GCATTTGACA 2 5 27 17 9 20 172129 Homo sapiens cDNA: FLJ21409 fis, clone COL03924 GCTTTTAAGG 2 8 14 32 16 17 8102 ribosomal protein S20 GGACCACTGA 18 39 76 57 48 83 119598 ribosomal protein L3 GGGGGTAACT 1 2 8 11 14 13 99969 fusion, derived from t(12;16) malignant liposarcoma GTGCGCTGAG 0 0 75 0 20 18 277477 major histocompatibility complex, class I, C GTGCTCATTC 0 0 13 7 2 10 116577 prostate differentiation factor GTGCTCATTC 0 0 13 7 2 10 25945 ESTs GTGTGTTTGT 0 0 17 29 17 15 118787 transforming growth factor, beta-induced, 68 kD GTTCGTGCCA 1 13 18 43 24 18 179606 nuclear RNA helicase, DECD variant of DEAD box family GTTCGTGCCA 1 13 18 43 24 18 179666 uncharacterized hypothalamus protein HSMNP1 TAATAAAGGT 4 11 37 62 24 27 151604 ribosomal protein S8 TAATTTTTGC 0 1 99 12 20 37 273321 differentially expressed in hematopoietic lineages TCACAAGCAA 10 7 17 21 13 38 146763 nascent-polypeptide-associated complex alpha polypeptide TCAGATCTTT 14 32 37 108 31 87 75344 ribosomal protein S4, X-linked TCCTGCCCCA 1 5 10 14 7 16 171814 parathymosin TGAAATAAAA 0 2 2 14 13 11 173205 nucleophosmin (nucleolar phosphoprotein B23, numatrin) TGAAATAAAA 0 2 2 14 13 11 192822 Human DNA sequence from clone RP5-1179L24 on chromosome 6q24.3-25.3. Contains the 3′ end of the gene for a novel protein similar to mouse phospholipase C neighboring protein PNG, ESTs, STSs and GSSs TGATGTCTGG 0 0 2 6 8 2 83883 transmembrane, prostate androgen induced RNA TGTAATCAAT 2 3 13 11 8 11 249495 heterogeneous nuclear ribonucleoprotein A1 TTACCATATC 10 5 22 30 26 22 300141 ribosomal protein L39. TTATGGGATC 6 4 24 37 36 47 5662 guanine nucleotide binding protein (G protein), beta polypeptide 2-like 1 TTCAATAAAA 8 14 79 111 36 50 177592 ribosomal protein, large, P1 TTCCAGCTGC 0 0 7 6 2 9 112442 ESTs, Weakly similar to TTCCAGCTGC 0 0 7 6 2 9 19121 adaptor-related protein complex 2, alpha 2 subunit TTCCAGCTGC 0 0 7 6 2 9 227277 sine oculis homeobox (Drosophila) homolog 3 TTTCCACTAA 0 0 8 4 4 6 1032 regenerating isler-derived 1 alpha (pancreatic stone protein, pancreatic thread protein) TTTCCACTAA 0 0 8 4 4 6 289088 heat shock 90 kD protein 1, alpha TTTTTAATGT 0 2 12 18 6 7 161307 H3 histone, family SA

TABLE 6 Tag_Sequence NC1 NC2 AD1 AD2 CA1 CA2 UNI ID Description AAATCTGGCA 16 15 2 4 2 0 430 plastin 1 (I isoform) AACGTGCAGG 29 31 13 6 7 8 160786 argininosuccinate synthetase AAGAAAGCTC 20 6 0 2 1 5 25264 DKFZP434N126 protein AAGAAAGCTC 20 6 0 2 1 5 91011 anterior gradient 2 (Xenepus laevis) homolog AAGAAGCAGG 8 16 3 4 1 3 11441 chromosome 1 open reading frame 8 AAGGTAGCAG 15 16 2 4 2 4 104125 adenylyl cyclase-associated protein AATAAAGGCT 25 11 3 7 3 4 179735 ras homolog gene family, member C AATAGTTTCC 7 16 2 3 6 1 272620 pregnancy specific beta-1-glycoprotein 9 AATCACAAAT 18 45 1 4 14 3 74466 carcinoembryonic antigen-related cell adhesion molecule 7 AATGAGAAGG 11 3 0 0 1 0 198248 UDP-Gal:betaGlcNAc beta 1,4-galactosyltransferase, polypeptide 1 ACAATTGGTC 0 10 0 0 0 0 155097 carbonic anhydrase II ACACCCATCA 2 27 1 0 5 3 110445 CGI-97 protein ACAGGGTGAC 25 13 1 8 7 6 174050 endothelial differentiation-related factor 1 ACATTGGGTG 377 334 67 34 96 33 275086 PR domain containing 10 ACATTGGGTG 377 334 67 34 96 33 5241 fatty acid binding protein 1, liver ACCCAACTGC 12 3 0 0 0 0 232604 Homo sapiens cDNA: FLJ22675 fis, clone HSI10553 ACCCACGTCA 22 10 3 5 3 1 198951 jun B proto-oncogene ACCCCCCCGC 44 38 7 13 16 6 229413 ESTs ACCCCCCCGC 44 38 7 13 16 6 2780 jun D proto-oncogene ACCTGCATCC 0 12 0 0 0 0 ACCTGGGGAG 35 11 1 3 4 3 131748 ESTs, Moderately similar to ACCTGGGGAG 35 11 1 3 4 3 209119 1-acylglycerol-3-phosphate O-acyltransferase 2 (lysophosphatidic acid acyltransferase, beta) ACGGTCCAGG 5 12 0 0 0 1 72924 cytidine deaminase ACTCTTGTTG 7 2 0 0 0 0 5378 spondin 1, (f-spondin) extracellular matrix protein ACTGTGGCGG 17 34 9 12 9 4 112242 ESTs AGAATAGCTT 44 67 3 9 11 30 24133 ESTs AGCAGGAGCA 50 14 6 3 7 6 178292 KIAA0180 protein AGCAGGAGCA 50 14 6 3 7 6 738 early growth response 1 AGCCCGACCA 16 8 2 4 1 3 104114 H. sapiens HCG I mRNA AGGATGGTCC 34 19 5 3 6 8 71779 Homo sapiens DNA from chromosome 19, cosmld F21856 AGGCCAAGGG 21 6 3 1 3 4 76057 galactose-4-epimerase, UDP AGGTGACTGG 10 14 0 0 0 0 AGTGGGCTCA 3 8 0 1 0 0 ATACTCCACT 82 59 0 0 10 3 778 guanylate cyclase activator 1B (retina) ATATAATCTG 18 14 1 4 5 5 621 lectin, galactoside-binding, soluble, 3 (galectin 3) ATCGTGGCGG 193 92 19 25 20 10 5372 claudin 4 ATGACGCTCA 22 18 6 5 3 4 8254 hypothetical protein PRO0899 ATGATGGCAC 12 32 1 0 1 0 84072 transmembrane 4 superfamily member 3 ATGCGGAGTC 14 13 5 3 2 4 25527 tight junction protein 3 (zona occludens 3) ATGCGGGAGA 38 39 15 22 5 6 109748 Homo sapiens CAC-1 mRNA, partial cds ATGGCACGGA 6 21 1 1 3 0 81097 cytochrome C oxidase subunit VIII ATGGTCTACG 10 5 0 0 1 0 96593 hypothetical protein ATGGTGGGGG 25 30 11 9 1 2 1665 zinc finger protein homologous to Zfp-36 in mouse ATGTGCGTGG 38 8 11 3 7 7 56937 suppression of tumorigenicity 14 (colon carcinoma, matriptase, epithin) ATGTGGGCTC 7 2 0 0 0 0 151641 glycoprotein A repetitions predominant ATGTGGGCTC 7 2 0 0 0 0 27018 Ris ATTGGAGTGC 136 85 15 36 37 19 220529 carcinoembryonic antigen-related cell adhesion molecule 5 ATTTCAAGAT 35 21 0 2 1 0 155097 carbonic anhydrase II ATTTCAAGAT 35 21 0 2 1 0 24453 ESTs CAAATAAAAG 9 12 2 0 1 1 185055 BENE protein CAAGAGTTTC 14 2 0 0 0 0 183617 ESTs CACCCCTGAT 73 169 58 58 13 36 173724 creatine kinase, brain CAGTGCGTTC 12 3 0 0 3 0 8302 four and a half LIM domains 2 CATAGGTTTA 66 39 4 1 5 0 1650 solute carrier family 26, member 3 CCAAAGCTAT 42 16 14 12 6 11 84072 transmembrane 4 superfamily member 3 CCAACACCAG 9 19 1 0 0 1 181165 eukaryotic translation elongation factor 1 alpha 1 CCACTGCACC 21 19 5 5 6 14 CCAGGGGAGA 45 66 24 22 10 20 278613 interferon, alpha-inducible protein 27 CCATTCCACT 13 1 2 0 0 0 CCCAACGCGC 106 1 3 5 0 2 272572 hemoglobin, alpha 2 CCCCCGAAGC 25 27 3 15 4 8 61265 ESTs, Weakly similar to CCCCCGCGGA 33 25 6 11 4 12 95697 liver-specific bHLH-Zip transcription factor CCCCCTGCAT 5 4 0 0 0 0 CCCGCCTCTT 0 40 3 3 16 1 mito Tag matches mitochondrial sequence CCCTCCCGAA 89 54 9 14 18 7 5940 hypothetical protein FLJ20063 CCGCTGCACT 127 102 55 46 37 30 CCGGCTTGAG 7 4 0 0 0 0 2722 inositol 1,4,5-trisphosphate 3-kinase A CCTCCAGCTA 715 458 142 125 131 147 242463 keratin 8 CCTCCAGTAC 20 8 2 3 2 4 CCTGCCCCCC 20 30 6 3 11 4 861 mitogen-activated protein kinase 3 CCTGCTGCAG 7 34 0 1 6 9 102482 mucin 5, subtype B, tracheobronchial CCTGCTTGTC 20 23 0 3 0 5 268171 ESTs, Weakly similar to CCTGCTTGTC 20 23 0 3 0 5 2719 epididymis-specific, whey-acidic protein type, four-disulfide core; putative ovarian carcinoma marker CCTGGAAGAG 30 26 11 4 12 16 75655 procollagen-proline, 2-oxoglutarate 4-dioxygenase (proline 4-hydroxylase), beta polypeptide (protein disulfide isomerase; thyroid hormone binding protein p55) CCTGTCTGCC 14 22 0 1 1 1 107139 hypothetical protein CCTGTGACAG 22 27 0 4 3 1 120 anti-oxidant protein 2 (non-selenium glutathione peroxidase, acidic calcium- independent phospholipase A2) CCTTCAAATC 29 17 0 0 1 0 23118 carbonic anhydrase I CGAGGGGCCA 110 47 18 18 12 32 182485 actinin, alpha 4 CGCTGTGGGG 58 53 19 8 8 6 7486 protein expressed in thyroid CGGACTCACT 20 45 5 14 14 10 284134 serologically defined colon cancer antigen 28 CGGACTCACT 20 45 5 14 14 10 84700 similar to phosphatidylcholine transfer protein 2 CGGGAGTCGG 28 30 13 2 9 1 236720 ESTs, Weakly similar to CGGTGGGACC 7 14 1 1 3 3 99175 Homo sapiens cDNA: FLJ21606 fis, clone COL07302 CGTGGGTGGG 1 10 1 0 0 1 202833 heme oxygenase (decycling) 1 CTAGCCTCAC 172 90 30 53 36 58 14376 actin, gamma 1 CTCAGAACTT 18 3 1 0 0 0 194710 glucosaminyl (N-acetyl) transferase 3, mucin type CTGAACCTCC 5 15 2 0 0 0 4205 hypothetical protein FLJ20124 CTGACCTGTG 88 130 48 18 16 46 77961 major histocompatibility complex, class I, B CTGGATCTGG 21 21 3 9 5 10 75658 phosphorylase, glycogen; brain CTGGCAAAGG 14 22 1 0 0 0 CTGGCCCTCG 186 52 1 3 15 14 1406 trefoil factor 1 (breast cancer, estrogen-inducible sequence expressed in) CTGGCCCTCG 186 52 1 3 15 14 166184 Intersectin 2 CTGGCCCTCG 186 52 1 3 15 14 7720 dynein, cytoplasmic, heavy polypeptide 1 CTGGCTATCC 7 3 0 0 0 1 10784 hypothetical protein FLJ20037 CTGGGCCTCT 22 22 2 2 3 3 50868 solute carrier family 22 (organic cation transporter), member 1-like CTGTACTTGT 9 5 1 1 0 0 75678 FBJ murine osteosarcoma viral oncogene homolog B CTGTGTGGCT 0 12 1 0 0 0 127610 acyl-Coenzyme A dehydrogenase, C-2 to C-3 short chain CTGTGTGGCT 0 12 1 0 0 0 54277 DNA segment on chromosome X (unique) 9928 expressed sequence CTTACAAGCA 21 13 2 3 4 3 mito Tag matches mitochondrial sequence CTTAGAGGGG 16 22 0 1 1 1 155191 villin 2 (ezrin) CTTATGGTCC 36 11 0 1 1 0 179608 retinol dehydrogenase homolog CTTCCAGCTA 64 31 22 20 14 19 217493 annexin A2 CTTCTTGCCC 29 2 2 2 0 1 251577 hemoglobin, alpha 1 CTTGACATAC 18 20 4 4 0 0 171695 dual specificity phosphatase 1 CTTGATTCCC 26 9 5 0 2 5 77266 quiescin Q6 GACATCAAGT 198 87 23 14 47 17 182265 keratin 19 GACCAGCCCA 23 21 3 2 12 5 75799 protease, serine, 8 (prostasin) GACCAGTGGC 21 44 4 0 2 0 143131 glycoprotein A33 (transmembrane) GACGCGGCGC 30 47 10 17 12 17 301684 RNA POLYMERASE I AND TRANSCRlPT RELEASE FACTOR GAGAGCTCCC 5 11 3 0 2 1 mito Tag matches mitochondrial sequence GAGCACCGTG 7 4 1 0 0 1 GATATGTAAA 1 10 0 0 0 0 GATCCCAACT 9 29 5 7 1 1 118786 metallothionein 2A GATGAATCCG 12 14 2 2 1 2 283552 ESTs, Weakly similar to GATGACCCCC 42 49 4 3 3 3 mito Tag matches mitochondrial sequence GCAAGAAAGT 48 0 0 4 0 1 155376 hemoglobin, beta GCACAGGTCA 5 9 1 0 1 1 GCACCCTTTC 13 5 0 0 1 0 GCACCTGTCG 2 9 0 0 1 0 109059 mitochondrial ribosomal protein L12 GCACCTGTCG 2 9 0 0 1 0 1239 alanyl (membrane) aminopeptidase (aminopeptidase N, aminopeptidase M, microsomal aminopeptidase, CD13, p150) GCAGCTCCTG 13 47 3 2 7 3 119257 ems1 sequence (mammary tumor and squamous cell carcinoma-associated (p80/85 src substrate) GCAGGAGGTG 2 13 0 0 0 1 11441 chromosome 1 open reading frame 8 GCAGGAGGTG 2 13 0 0 0 1 78040 KDEL (Lys-Asp-Glu-Leu) endoplasmic reticulum protein retention receptor 1 GCAGGGCCTC 128 165 41 69 39 51 92323 FXYD domain-containing Ion transport regulator 3 GCCACATACT 3 9 0 0 0 0 4984 KIAA0828 protein GCCACGTGGA 19 16 5 2 7 1 103665 villin-like GCCAGACACC 19 9 3 4 1 2 3804 DKFZP564C1940 protein GCCAGGTTGC 14 5 1 1 1 1 42824 hypothetical protein FLJ10718 GCCAGGTTGC 14 5 1 1 1 1 55682 eukaryotic translation initiation factor 3, subunit 7 (zeta, 66/67 kD) GCCAGGTTGC 14 5 1 1 1 1 78996 proliferating cell nuclear antigen GCCATCCTCC 9 13 0 1 0 0 GCCCACACAG 15 0 1 1 0 0 1690 heparin-binding growth factor binding protein GCCCACGTCA 7 8 0 0 0 0 GCCCAGGGCC 4 44 2 1 2 1 10326 coatomer protein complex, subunit epsilon GCCCAGGGCC 4 44 2 1 2 1 229417 EST, Moderately similar to GCCCAGGGCC 4 44 2 1 2 1 229546 EST GCCCAGGTCA 519 447 136 128 58 22 154903 ESTs, Weakly similar to GCCCAGTGGC 51 0 8 15 2 5 143131 glycoprotein A33 (transmembrane) GCCGACCAGG 46 47 15 8 19 9 75741 amiloride binding protein 1 (amine oxidase (copper-containing)) GCCGGGTGGG 207 149 18 24 68 67 74631 basigin GCCGTGGAGA 32 23 4 11 7 7 80680 major vault protein GCCTGGCCAT 26 34 4 6 10 14 5662 guanine nucleotide binding protein (G protein), beta polypeptide 2-like 1 GCCTGGCCAT 26 34 4 6 10 14 63042 DKFZp564J157 protein GCGAAACCCT 167 565 123 43 64 98 GCGAAACTCG 5 9 1 0 0 0 GCGCAGAGGT 2 16 1 0 0 1 108124 ribosomal protein L41 GCTCTTCCCC 9 21 1 2 2 0 33455 peptidyl arginine deiminase, type II GCTGCCCTTG 44 6 13 6 6 18 272897 Tubulin, alpha, brain-specific GCTGCCCTTG 44 6 13 6 6 18 278242 tubulin, alpha, ubiquitous GCTGGCACAT 15 14 1 0 6 0 179704 meprin A, alpha (PABA peptide hydrolase) GCTGGCCCCG 5 11 0 0 0 1 8185 CGI-44 protein; sulfide dehydrogenase like (yeast) GCTGTGCCTG 36 42 2 4 11 8 58247 protease, serine, 4 (trypsin 4, brain) GCTTGGGGAT 11 8 2 0 0 0 5394 myosin, heavy polypeptide-like (110 kD) GGAACAGGGG 1 13 1 0 0 2 102336 Rho GTPase activating protein 8 GGAACAGGGG 1 13 1 0 0 2 272972 hypothetical protein FLJ20185 GGAACAGGGG 1 13 1 0 0 2 77961 major histocompatibility complex, class I, B GGAACTGTGA 90 84 10 18 10 2 38972 tetraspan 1 GGAAGAGCAC 21 11 1 1 2 5 75268 sialyltransferase 4C (beta-galactosidase alpha-2,3-sialytransferase) GGAGGCCGAG 13 9 5 0 2 5 301342 ESTs, Weakly similar to GGAGGCGCTC 5 11 1 1 0 1 33455 peptidyl arginine deiminase, type II GGATGGCTTA 25 5 2 1 1 1 64179 hypothetical protein GGCACCGTGC 22 44 8 10 8 4 120912 ESTs GGCCCTGCAG 14 7 1 0 5 1 105463 sir2-related protein type 6 GGCTCGGGAT 15 11 2 4 3 5 2575 calpain 1, (mu/l) large subunit GGCTGCCTGC 13 11 4 3 5 2 180958 ESTs GGCTGCCTGC 13 11 4 3 5 2 197314 ESTs GGCTGGGCCT 46 25 14 5 10 8 144102 EST GGCTGGGCCT 46 25 14 5 10 8 14846 Homo sapiens mRNA; cDNA DKFZp564D016 (from clone DKFZp564D016) GGCTGGGCCT 46 25 14 5 10 8 73919 clathrin, light polypeptide (Lcb) GGGAAGCAGA 32 17 18 4 8 9 GGGACGAGTG 20 6 1 3 6 1 3337 transmembrane 4 superfamily member 1 GGGCGCTGTG 11 27 3 6 4 5 8372 ubiquinol-cytochrome c reductase (6.4 kD) subunit GGGGCAGGGC 48 64 27 10 15 31 119140 eukaryotic translation initiation factor 5A GGTGAAGAGG 16 32 5 3 10 9 233950 serine protease inhibitor, Kunitz type 1 GTAGCAGGTG 24 27 11 7 7 7 140452 cargo selection protein (mannose 6 phosphate receptor binding protein) GTATTGGGGC 5 7 0 0 0 0 GTCATCACCA 35 22 0 0 0 0 107382 KIAA1517 protein GTCATCACCA 35 22 0 0 0 0 257045 Homo sapiens cDNA: FLJ23415 fis, clone HEP20738 GTCATCACCA 35 22 0 0 0 0 32966 guanylate cyclase activator 2B (uroguanylin) GTCATCACCA 35 22 0 0 0 0 68877 cytochrome b-245, alpha polypeptide GTCCGAGTGC 17 3 0 0 0 0 3337 transmembrane 4 superfamily member 1 GTCCTGAACA 7 3 0 0 0 0 78546 ATPase, Ca++ transporting, plasma membrane 1 GTCCTGAACA 7 3 0 0 0 0 8258 DKFZP434D1335 protein GTGCACTGAG 118 48 14 7 12 13 181244 major histocompatibility complex, class I, A GTGCACTGAG 118 45 14 7 12 13 277477 major histocompatibility complex, class I, C GTGCCTGAGA 18 15 2 6 7 3 77886 lamin A/C GTGGCGGGAA 3 15 1 0 4 0 GTGGGGGCGC 5 22 2 0 1 0 254105 enolase 1, (alpha) GTGGTGGCAG 29 11 1 1 10 3 194691 retinoic acid induced 3 GTGGTTCACG 4 5 0 0 0 0 272088 ESTs, Moderately similar to GTGGTTCACG 4 5 0 0 0 0 62192 coagulation factor III (thromboplastin, tissue factor) GTGTTGGGGG 21 19 8 6 1 3 55016 hypothetical protein FLJ21935 GTTTAGAGGG 5 16 0 0 2 1 181874 interferon-induced protein with tetratricopeptide repeats 4 TAAATTGCAA 103 59 8 17 5 3 56205 Insulin induced gene 1 TAAGGCCTTT 6 9 1 0 0 1 20149 deleted in lymphocytic leukemia, 1 TAAGGCCTTT 6 9 1 0 0 1 42945 acid sphingomyelinase-like phosphodiesterase TAATCCCAGC 37 33 8 7 16 13 TAATTTGCAT 25 2 1 1 2 0 79368 epithelial membrane protein 1 TACGGTGTGG 7 13 2 2 1 0 105460 DKFZP56400823 protein TACTCGGCCA 10 5 0 0 1 0 79474 tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein, epsilon polypeptide TACTGTGGAT 4 11 0 2 2 1 21537 protein phosphatase 1, catalytic subunit, beta isoform TAGACTAGCA 31 27 6 6 22 4 100090 tetraspan 3 TAGGATGGGG 24 30 4 7 6 1 76941 ATPase, Na+/K+ transporting, beta 3 polypeptide TATGATGAGC 13 21 2 2 1 5 205126 Homo sapiens cDNA: FLJ22667 fis, clone HSI08385 TCACAGTGCC 26 7 3 1 3 4 81008 filamin B, beta (actin-binding protein-278) TCACCGGTCA 118 75 10 10 5 6 290070 gelsolin (amyloidosis, Finnish type) TCAGAGCGCT 5 21 0 7 0 1 92323 FXYD domain-containing ion transport regulator 3 TCAGCTGCAA 56 16 0 0 9 3 284199 mucin 12 TCAGCTGCAA 56 16 0 0 9 3 301888 Homo sapiens cDNA FLJ11205 fis, clone PLACE1007843 TCGGAGCTGT 21 20 9 6 3 0 4055 G protein-coupled receptor kinase-interactor 1 TCTGAATTAT 24 16 0 0 1 0 50964 carcinoembryonic antigen-related cell adhesion molecule 1 (biliary glycoprotein) TGACTAATTG 7 9 2 0 0 3 293380 ESTs TGAGTGACAG 9 68 0 6 3 7 205126 Homo sapiens cDNA: FLJ22667 fis, clone HSI08385 TGAGTGACAG 9 68 0 6 3 7 271888 ESTs TGATCTCTGT 6 7 1 0 1 1 30738 hypothetical protein FLJ10407 TGCAGCACGA 6 185 5 30 24 16 110309 major histocompatibility complex, class I, F TGCAGCGCCT 16 9 1 1 1 1 77573 uridine phosphorylase TGCCGCCCGC 14 5 2 2 1 0 202097 procollagen C-endopeptidase enhancer TGCTCCTACC 140 113 70 22 17 22 111732 Fc fragment of IgG binding protein TGCTCCTACC 140 113 70 22 17 22 301256 Homo sapiens chromosome 19, cosmid R30669 TGGCCATCTG 30 24 8 7 3 4 184052 PP1201 protein TGGCGCGTGT 25 8 0 0 9 5 25640 claudin 3 TGGCTACTTA 6 9 1 0 1 2 117950 multifunctional polypeptide similar to SAICAR synthetase and AIR carboxylase TGGGGAGAGG 43 18 20 7 3 7 288998 S100-type calcium binding protein A14 TTAACCCCTC 34 14 5 9 1 5 78224 ribonuclease, RNase A family, 1 (pancreatic) TTATGGTGTG 11 17 0 0 0 0 271499 ESTs TTCCACTAAC 29 9 7 4 5 5 79706 plectin 1, intermediate filament binding protein, 500 kD TTCCGCGTTC 5 16 0 0 2 2 137274 ESTs, Weakly similar to TTCTGGTGCG 8 2 0 0 1 0 119251 ubiquinol-cytochrome c reductase core protein 1 TTCTGTAGCC 13 23 4 2 4 2 5541 ATPase, Ca++ transporting, ubiquitous TTGGACCTGG 33 31 7 18 12 16 89761 ATP synthase, H+ transporting, mitochondrial F1 complex, delta subunit TTGGGGTTTC 111 184 50 81 67 50 62954 ferritin, heavy polypeptide 1 TTTAACGGCC 93 67 36 35 11 30 mito Tag matches mitochondrial sequence TTTCCTCTCA 21 8 6 2 4 3 184510 stratifin TTTCCTCTCA 21 8 6 2 4 3 303400 ESTs TTTCTCGTCG 10 16 2 3 0 2 1686 guanine nucleotide binding protein (G protein), alpha 11 (Gq class) TTTGGTTTCA 2 13 0 0 0 0 carcinoembryonic antigen-related cell adhesion molecule 1 (biliary TTTTCTGCAT 8 7 1 0 1 2 50964 glycoprotein) TTTTCTGCAT 8 7 1 0 1 2 77318 platelet-activating factor acetylhydrolase, isoform lb, alpha subunit (45 kD) TTTTTACTGA 32 19 10 10 8 1 111577 integral membrane protein 2C

REFERENCES

-   1. Cancer Facts & FIGS. 1998: American Cancer Society, 1998. -   2. Inger, D. B. Colorectal cancer screening, Prim Care. 26: 179-187,     1999. -   3. Velculescu, V. E., Zhang, L., Vogelstein, B., and Kinzler, K. W.     Serial Analysis Of Gene Expression, Science. 270: 484-487, 1995. -   4. Zhang, L., Zhou, W., Velculescu, V. E., Kern, S. E., Hruban, R.     H., Hamilton, S. R., Vogelstein, B., and Kinzler, K. W. Gene     Expression Profiles in Normal and Cancer Cells, Science. 276:     1268-1272, 1997. -   5. Lal, A., Lash, A. E., Altschul, S. F., Velculescu, V., Zhang, L.,     McLendon, R. E., Marra, M. A., Prange, C., Morin, P. J., Polyak, K.,     Papadopoulos, N., Vogelstein, B., Kinzler, K. W., Strausberg, R. L.,     and Riggins, G. J. A public database for gene expression in human     cancers, Cancer Res. 59: 5403-5407, 1999. -   6. St Croix, B., Rago, C., Velculescu, V., Traverso, G., Romans, K.     E., Montgomery, E., Lal, A., Riggins, G. J., Lengauer, C.,     Vogelstein, B., and Kinzler, K. W. Genes expressed in human tumor     endothelium, Science. 289: 1197-1202, 2000. -   7. Guy-Crotte, O., Amouric, M., and Figarella, C. Characterization     and N-terminal sequence of a degradation product of 14,000 molecular     weight isolated from human pancreatic juice, Biochem Biophys Res     Commun. 125: 516-523, 1984. -   8. Terazono, K., Yamamoto, H., Takasawa, S., Shiga, K., Yonemura,     Y., Tochino, Y., and Okamoto, H. A novel gene activated in     regenerating islets, J Biol Chem. 263: 2111-2114,1988. -   9. Watanabe, T., Yonekura, H., Terazono, K., Yamamoto, H., and     Okamoto, H. Complete nucleotide sequence of human reg gene and its     expression in normal and tumoral tissues. The reg protein,     pancreatic stone protein, and pancreatic thread protein are one and     the same product of the gene, J Biol Chem. 265: 7432-7439, 1990. -   10. Rechreche, H., Montalto, G., Mallo, G. V., Vasseur, S., Marasa,     L., Soubeyran, P., Dagorn, J. C., and Iovanna, J. L. pap, reg Ialpha     and reg Tbeta mRNAs are concomitantly up-regulated during human     colorectal carcinogenesis, Int J Cancer. 81: 688-694, 1999. -   11. Skonier, J., Neubauer, M., Madisen, L., Bennett, K., Plowman, G.     D., and Purchio, A. F. cDNA cloning and sequence analysis of beta     ig-h3, a novel gene induced in a human adenocarcinoma cell line     after treatment with transforming growth factor-beta, DNA Cell Biol.     11: 511-522, 1992. -   12. Escribano, J., Hernando, N., Ghosh, S., Crabb, J., and     Coca-Prados, M. cDNA from human ocular ciliary epithelium homologous     to beta ig-h3 is preferentially expressed as an extracellular     protein in the corneal epithelium, J Cell Physiol. 160: 511-521,     1994. -   13. Munier, F. L., Korvatska, E., Djemai, A., Le Paslier, D.,     Zografos, L., Pescia, G., and Schorderet, D. F. Kerato-epithelin     mutations in four 5q31-linked corneal dystrophies, Nat Genet. 15:     247-251, 1997. -   14. Fleming, A. On a remarkable bacteriolytic element found in     tissues and secretions, Proceedings of the Royal Society. 93:     306-317, 1922. -   15. Sugi, K., Saitoh, O., Hirata, I., and Katsu, K. Fecal     lactoferrin as a marker for disease activity in inflammatory bowel     disease: comparison with other neutrophil-derived proteins, Am J     Gastroenterol. 91: 927-934, 1996. -   16. van der Sluys Veer, A., Brouwer, J., Biemond, I., Bohbouth, G.     E., Verspaget, H. W., and Lamers, C. B. Fecal lysozyme in assessment     of disease activity in inflammatory bowel disease, Dig Dis Sci. 43:     590-595, 1998. -   17. Tomita, H., Sato, S., Matsuda, R., Sugiura, Y., Kawaguchi, H.,     Niimi, T., Yoshida, S., and Morishita, M. Serum lysozyme levels and     clinical features of sarcoidosis, Lung. 177: 161-167, 1999. -   18. Ho, S. B., Itzkowitz, S. H., Friera, A. M., Jiang, S. H., and     Kim, Y. S. Cell lineage markers in premalignant and malignant     colonic mucosa, Gastroenterology. 97: 392404, 1989. -   19. Yamada, R. and Kera, Y. D-amino acid hydrolysing enzymes, Exs.     85: 145-155, 1998. -   20. Bootcov, M. R., Bauskin, A. R., Valenzuela, S. M., Moore, A. G.,     Bansal, M., He, X. Y., Zhang, H. P., Donnellan, M., Mahler, S.,     Pryor, K., Walsh, B. J., Nicholson, R. C., Fairlie, W. D., Por, S.     B., Robbins, J. M., and Breit, S. N. MIC-1, a novel macrophage     inhibitory cytokine, is a divergent member of the TGF-beta     superfamily, Proc Natl Acad Sci U S A. 94: 11514-11519, 1997. -   21. Paralkar, V. M., Vail, A. L., Grasser, W. A., Brown, T. A., Xu,     H., Vukicevic, S., Ke, H. Z., Qi, H., Owen, T. A., and     Thompson, D. D. Cloning and characterization of a novel member of     the transforming growth factor-beta/bone morphogenetic protein     family, J Biol Chem. 273: 13760-13767, 1998. -   22. Notterman, D. A., Alon, U., Sierk, A. J., Levine, A. J.,     Transcriptional Gene Expression Profiles of Colorectal Adenoma,     Adenocarcinoma, and Normal Tissue Examined by Oligonucleotide     Arrays, Cancer Res. 61: 3124-3130, 2001. -   23. Zhou, W., Sokoll, L. J., Brusek, D. J., Zhang, L., Velculsescu,     V., Goldin, S. B., Hruban, R. H., Kem, S. E., Hamilton, S. R.,     Chan, D. W., Vogelstein, B., and Kinzier, K. W. Identifying markers     for pancreatic cancer by gene expression analysis, Can Epid Bio &     Prev. 7. 109-112, 1998. -   24. Brown, D. A., Liu, T., Ward, R. L., Hawkins, N. J., Fairlie, W.     D., Bauskin, A. R., Russell, P. J., Quinn, D. I., Grygiel, J. J.,     Moore, A. G., Sutherland, R. L., Turner, J., Kingsley, E. A., and     Breit, S. N. Macrophage Inhibitory Cytokine-1 (MIC-1) in epithelial     neoplasia, Submitted., 2001. 

1. A method for detection of colorectal cancer, comprising the steps of: detecting renal dipeptidase in blood of a subject; and comparing the amount of renal dipeptidase in blood of the subject to the amount of renal dipeptidase in normal subjects; detecting an elevated amount of renal dipeptidase in the blood of the subject which is an indicator of colorectal cancer in the subject.
 2. A method for detection of colorectal cancer, comprising the steps of: detecting renal dipeptidase in feces of a subject; and comparing the amount of renal dipeptidase in feces of the subject to the amount of renal dipeptidase in normal subjects; detecting an elevated amount of renal dipeptidase in the feces of the subject which is an indicator of colorectal cancer in the subject.
 3. The method of claim 1 further comprising: determining if the renal dipeptidase detected in the blood comprises a tumor-specific glycoform of renal dipeptidase.
 4. The method of claim 2 further comprising: determining if the renal dipeptidase detected in the feces comprises a tumor-specific glycoform of renal dipeptidase.
 5. The method of claim 1 further comprising: determining if the renal dipeptidase detected in the blood binds to L lectin from Phaseolus vulgaris hemagglutinin.
 6. The method of claim 2 further comprising: determining if the renal dipeptidase detected in the feces binds to L lectin from Phaseolus vulgaris hemagglutinin.
 7. The method of claim 1 further comprising: determining if the renal dipeptidase detected in the blood binds to L lectin from Sambucus nigra hemagglutinin.
 8. The method of claim 2 further comprising: determining if the renal dipeptidase detected in the feces binds to L lectin from Sambucus nigra hemagglutinin.
 9. The method of claim 1 wherein the normal subjects are tumor free.
 10. The method of claim 1 wherein the normal subjects are tumor free as determined by colonoscopy.
 11. The method of claim 1 further comprising: indicating that the subject has a marker for colorectal cancer.
 12. The method of claim 2 wherein the normal subjects are tumor free.
 13. The method of claim 2 wherein the normal subjects are tumor free as determined by colonoscopy.
 14. The method of claim 2 further comprising: indicating that the subject has a marker for colorectal cancer.
 15. The method of claim 1 wherein the subject is presymptomatic.
 16. The method of claim 2 wherein the subject is presymptomatic.
 17. The method of claim 1 wherein the subject has metastatic colon cancer.
 18. The method of claim 2 wherein the subject has metastatic colon cancer. 